RESERVE BANK OF INDIA SERVICES BOARD, MUMBAI

APPLICATION FOR THE POST OF EXECUTIVE INTERNS (ON CONTRACT BASIS)

Advt No. 1A/2010-11

1) NAME IN FULL (IN ENGLISH WITH CAPITAL LETTERS): RECEIPT NO :
FEE PAID :
.....................................................................................................
(FOR OFFICE USE)
2) CATEGORY:
A) WRITE GEN for General / SC for Scheduled Caste / ST for Sched-
uled Tribe / OBC for Other Backward Class. (OBC candidates coming
PASTE A SIGNED
under ‘Creamy Layer’ should indicate their category as GEN). This
LATEST PASSPORT
column should not be kept blank
SIZE PHOTOGRAPH
B) PH(PWD) Category WRITE OH for Orthopaedically Handicapped, HI DO NOT STAPLE
for Hearing Impaired and VH for Visually Handicapped in addition to
the main Category in A above (Others leave it Blank)

3)
EXAMINATION CENTRE CENTRE CODE

4) GENDER: Write M for Male and F for Female

DATE MONTH YEAR
5) DATE OF BIRTH:

6) AGE (AS ON 01.07.2010) YEARS MONTHS

7) ACADEMIC QUALIFICATIONS (AS ON 01.07.2010)

Qualification Main Subjects Date of University/Institute Overall % Class/

Result of marks Division
(Up to two dec.points)

Graduation

Information Technology

8) PARTICULARS OF EXAMINATION FEE:

Name of the Drawee Bank/Post Office No. & Date of DD/Indian Postal Order/s Amount in Rs.

9) POSTAL ADDRESS
(IN ENGLISH AND IN CAPITAL LETTERS
- DO NOT WRITE NAME)

STATE: PIN:

E-mail Address, if any:

Telephone No.
with STD code, if any:

I hereby declare that all the statements made in this application are true, complete and correct to the best of my
knowledge and belief. I understand that if at any stage, it is found that any information given in this application is
false/incorrect or that I do not satisfy the eligibility criteria according to the Board, my candidature/appointment is
liable to be cancelled /terminated. I have read and understood the stipulation given in the advertisement and hereby
undertake to abide by them.

PLACE : (Signature of the Applicant)

DATE : NAME:

Very Important points to be noted by the candidates :-

I) Candidates must complete the application in all respects including pasting of photograph.
II) Incomplete application in any respect will be rejected and no correspondence will be entertained by the Board in this matter.